Virtual Reality as a Therapy Tool for Walking Activities in Pediatric Neurorehabilitation: Usability and User Experience Evaluation

Background: Many essential walking activities in daily life, such as crossing a street, are challenging to practice in conventional therapeutic settings. Virtual environments (VEs) delivered through a virtual reality (VR) head-mounted display (HMD) would allow training such activities in a safe and attractive environment. Furthermore, the game-like character and high degree of immersion in these applications might help maintain or increase children's motivation and active participation during the rehabilitation process. Objective: This study aimed to investigate the usability, user experience, and acceptability of an immersive VE experienced through a VR HMD to train everyday life walking activities in pediatric neurorehabilitation. Methods: In a cross-sectional study, 21 youths (median age 12.1 years; range 6.8-17.7 years) with a neuromotor impairment undergoing inpatient or outpatient neurorehabilitation tested a VE experienced through the VR HMD Oculus Quest. The participants, accompanied by their physiotherapists, moved freely around a 4.4 by 10-meter VE, displaying a magical forest and featuring various gamified everyday activities in different game designs. Using their hands, represented in the VE, the participants could interact with the virtual objects placed throughout the VE and trigger visual and auditory feedback. Symptoms of cybersickness were checked, and usability, user experience, and acceptability were evaluated using customized questionnaires with a visual analog scale for youths and a 5-point Likert scale for their therapists. Results: None of the participants reported any signs of cybersickness after 20 minutes of VR HMD exposure time. They rated comfort (median 10/10) and movement ability (median 10/10) with the VR HMD as high. The VE was perceived as being really there by the majority (median 8/10), and the participants had a strong feeling of spatial presence in the VE (median 9.5/10). They enjoyed exploring the virtual world (median 10/10) and liked this new therapy approach (median 10/10). Therapists' acceptance of the VR HMD was high (4/5). There were 5 patients that needed more support than usual, mainly for supervision, when moving around with the VR HMD. Otherwise, therapists felt that the VR HMD hardly affected their patients' movement behavior (median 4.75/5), whereas it seemed to increase their level of therapy engagement (median 4/5) compared to conventional physiotherapy sessions. Conclusions: This study demonstrates the usability of an immersive VE delivered through a VR HMD to engage youths in the training of everyday walking activities. The participants' and therapists' positive ratings on user experience and acceptance further support the promising application of this technology as a future therapeutic tool in pediatric neurorehabilitation. Keywords: adolescent; auditory; child; feasibility study; feedback; head-mounted display; pediatric; rehabilitation; therapy; tool; usability; user; virtual reality; visual; walking; youth

Object Manipulation in Virtual Reality Under Increasing Levels of Translational Gain

Room-scale Virtual Reality (VR) has become an affordable consumer reality, with applications ranging from entertainment to productivity. However, the limited physical space available for room-scale VR in the typical home or office environment poses a significant problem. To solve this, physical spaces can be extended by amplifying the mapping of physical to virtual movement (translational gain). Although amplified movement has been used since the earliest days of VR, little is known about how it influences reach-based interactions with virtual objects, now a standard feature of consumer VR. Consequently, this paper explores the picking and placing of virtual objects in VR for the first time, with translational gains of between 1x (a one-to-one mapping of a 3.5m*3.5m virtual space to the same sized physical space) and 3x (10.5m*10.5m virtual mapped to 3.5m*3.5m physical). Results show that reaching accuracy is maintained for up to 2x gain, however going beyond this diminishes accuracy and increases simulator sickness and perceived workload. We suggest gain levels of 1.5x to 1.75x can be utilized without compromising the usability of a VR task, significantly expanding the bounds of interactive room-scale VR

An Investigation of the Perceptions of Community Residents and Volunteer Researchers for the Community Health of the Clarke Square Neighborhood

The study explored the similarities and differences in community residents’ perceptions and volunteer researchers’ perceptions of community health indicators in the Clarke Square Neighborhood. The study sought to identify noteworthy differences between community residents’ perceptions and volunteer researchers’ perceptions, indicating the importance of including community members in community health research. In the study, community residents in the Clarke Square Neighborhood conducted a survey that had previously been done by volunteer researchers from the Urban Ecology Center and the Medical College of Wisconsin regarding community health indicators in the Clarke Square Neighborhood. The study also included a focus group, which discussed the perceptions of community residents and volunteer researchers regarding community health in the Clarke Square Neighborhood and the role that communities play in research. The study found several noteworthy differences in the perceptions of community residents and volunteer researchers regarding community health in the Clarke Square Neighborhood

Natural User Interface for Education in Virtual Environments

Education and self-improvement are key features of human behavior. However, learning in the physical world is not always desirable or achievable. That is how simulators came to be. There are domains where purely virtual simulators can be created in contrast to physical ones. In this research we present a novel environment for learning, using a natural user interface. We, humans, are not designed to operate and manipulate objects via keyboard, mouse or a controller. The natural way of interaction and communication is achieved through our actuators (hands and feet) and our sensors (hearing, vision, touch, smell and taste). That is the reason why it makes more sense to use sensors that can track our skeletal movements, are able to estimate our pose, and interpret our gestures. After acquiring and processing the desired – natural input, a system can analyze and translate those gestures into movement signals

Analysis of distracted pedestrians' waiting time: Head-Mounted Immersive Virtual Reality application

This paper analyzes the distracted pedestrians' waiting time before crossing the road in three conditions: 1) not distracted, 2) distracted with a smartphone and 3) distracted with a smartphone in the presence of virtual flashing LED lights on the crosswalk as a safety measure. For the means of data collection, we adapted an in-house developed virtual immersive reality environment (VIRE). A total of 42 volunteers participated in the experiment. Participants' positions and head movements were recorded and used to calculate walking speeds, acceleration and deceleration rates, surrogate safety measures, time spent playing smartphone game, etc. After a descriptive analysis on the data, the effects of these variables on pedestrians' waiting time are analyzed by employing a cox proportional hazard model. Several factors were identified as having impact on waiting time. The results show that an increase in initial walk speed, percentage of time the head was oriented toward smartphone during crossing, bigger minimum missed gaps and unsafe crossings resulted in shorter waiting times. On the other hand, an increase in the percentage of time the head was oriented toward smartphone during waiting time, crossing time and maze solving time, means longer waiting times for participants.Comment: Published in the proceedings of Pedestrian and Evacuation Dynamics 201

Gaze Strategies During Obstacle Negotiation in the Presence of Distractors: a Virtual Reality Based Assessment

Vision actively influences the gait, and older adults show altered visual patterns compared to their younger counterpart when approaching challenges in the travel path. Attentional distractors influence the motor strategies during obstacle crossing. In rehabilitation, treadmill and virtual reality (VR) are commonly used to train gait. The VR technology allows for repeatable, safe and full variable control tasks and is well accepted by the patients. The gaze behavior when watching at videos of a first perspective walking is similar to that adopted in the real world and the training of the gaze is effective to improve the accuracy of the gait. Therefore, the integration of the gaze monitoring in existing VR-based gait rehabilitation protocols could both give insights in the visuo-motor strategy adopted in challenging conditions and could improve the gait rehabilitation effectiveness. The research presented in this thesis consisted in the assessment of the visuo-motor strategies of young and older adults during obstacles crossing in a projected VR environment with visual distractors. The first part of the project consisted in testing a set-up allowing for such an assessment with a remote eye-tracking system. The tested remote eye-tracker was demonstrated to be reliable for treadmill walking, with gaze measurements comparable to those got for the static conditions. The second part of the project aimed at studying the effect of distractors during obstacle avoidance, by making young and older adults walking on a treadmill while navigating a purposely depicted VR world. Young and older adults showed different visual scan patterns of the scene. This study highlights the visuo-motor strategy of young and older adults in a set-up similar to those recently used in gait rehabilitation and showed that the two populations are distinguishable by the adopted visual strategy. This and further investigations are important to address better the gait rehabilitation interventions

Generalized Regressive Motion: a Visual Cue to Collision

Brains and sensory systems evolved to guide motion. Central to this task is controlling the approach to stationary obstacles and detecting moving organisms. Looming has been proposed as the main monocular visual cue for detecting the approach of other animals and avoiding collisions with stationary obstacles. Elegant neural mechanisms for looming detection have been found in the brain of insects and vertebrates. However, looming has not been analyzed in the context of collisions between two moving animals. We propose an alternative strategy, Generalized Regressive Motion (GRM), which is consistent with recently observed behavior in fruit flies. Geometric analysis proves that GRM is a reliable cue to collision among conspecifics, whereas agent-based modeling suggests that GRM is a better cue than looming as a means to detect approach, prevent collisions and maintain mobility

The relative importance of visual and sound design in the rehabilitation of a bridge connecting a highly populated area and a park

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